Comparison of post-operative inflammation using irrigating solution with and without heparin in patients with traumatic cataract

Mahtab Haider; Tayyaba Gul Malik

doi:10.24911/BioMedica/5-1236

Author(s)

Mahtab Haider Department of Ophthalmology, Lahore General Hospital, Lahore, Pakistan.

Tayyaba Gul Malik Department of Ophthalmology, Lahore General Hospital, Lahore, Pakistan.

Abstract

The role of heparin in managing post-operative inflammation has been debated. Some studies suggest that heparin can reduce inflammation by inhibiting inflammatory mediators, while others argue that its anticoagulant properties could potentially worsen the inflammation. This study was designed to compare post-operative inflammation in patients undergoing traumatic cataract surgery with and without heparin added to the irrigating solution. Methods: This quasi-experimental study was conducted in the Department of Ophthalmology at Lahore General Hospital Lahore from April 2023 to April 2024. A total of 48 patients with traumatic cataracts were divided by consecutive sampling into two groups (24 in each). Group A underwent surgery using heparin in the irrigating solution, while Group B had surgery without it. All patients were followed up on Day 1, Week 1, and aeftr 1 month. Post-operative intraocular reaction was documented and compared. An Independent sample t-test was used to compare the numeric data. The chi-square test and Fisher's exact test were used to compare post-operative inflammation. Results: The mean age of the patients was 12.29 ± 8.33 years. On day 1, Group A showed fewer Grade 1 cells in the anterior chamber (8.3% vs. 20.8%), with no statistically significant diefrences between the two groups (p = 0.61). Corneal edema had minimal variation between the groups (p = 0.77). By day 30, Group A, however, had no corneal edema in 91% of patients, while Group B had edema in 66% of cases. Pupillary membrane formation was slightly more common (12.5% vs. 8.3%) in Group B on day 1. Conclusion: The use of heparin may have a beneficial eefct in reducing post-operative inflammation in traumatic cataract surgery. However, the diefrence between the two groups was not statistically significant.

Publication Details

Page(s) 191-196

DOI 10.24911/BioMedica/5-1236

Published Journal: Biomedica, Volume: 40, Issue: 4, Year: 2024

Request the full text from PASTIC

Keywords

traumatic cataract, Heparin, Post-operative Inflammation, irrigation solution

References

Naidoo K,Kempen JH,Gichuhi S,Braithwaite T,Casson RJ,Cicinelli MV .2020 .Prevalence and causes of vision loss in sub-Saharan Africa in 2015: magnitude, temporal trends and projections. -315217, 104(12) : 1658-68.

Lever R,Page CP .2012 .Non-anticoagulant effects of heparin: an overview. Handb Exp Pharmacol, : 12-305.

Caça I,Sahin A,Cingü AK,Ari S,Alakuş F,Cinar Y .2012 .Effect of low molecular weight heparin (enoxaparin) on congenital cataract surgery. Int J Ophthalmol, 05(5) : 3959-9.

Vasavada VA,Praveen MR,Shah SK,Trivedi RH,Vasavada AR .2012 .Anti-inflammatory effect of low-molecular-weight heparin in pediatric cataract surgery: a randomized clinical trial. Am J Ophthalmol, 02(2) : 252-8.

Yousif H,Chohan A,Ahsan M.,Am J P Sci M. .2021 .Effect of heparin on postoperative inflammation after cataract surgery in diabetics. , 8(1) : 1-5.

Ganekal S,Dorairaj S,Ganekal V .2021 .Effect of heparin sodium on postoperative inflammation after adult cataract surgery. Indian J Clin Exp Ophthalmol, 7(4) : 15575-702.

Trusko B,Thorne J,Jabs D,Belfort R,Dick A,Gangaputra S .2013 .Development of a clinical evidence base utilizing informatics tools and techniques. Methods Inf Med, 52(3) : 259-65.

Okoye GS,Gurnani B. Traumatic cataract. .2024 .Aug 27. Treasure Island, : .

Karamat B,Azhar J .2019 .Frequency and characteristics of ocular trauma in a tertiary care hospital in Lodhran. Pak J Ophthalmol, 34(2) : 953-21.

Jamil AZ,Bahoo MLA .2020 .Visual outcome of ocular trauma presenting in a tertiary care hospital in Sahiwal. Pak J Ophthalmol, 36(2) : 987-5.

Hansen NC,Erichsen JH,Holm LM,Kessel L .2021 .Corneal thickness and anterior chamber flare after cataract surgery: a randomized controlled trial comparing five regimens for antiinflammatory prophylaxis. Clin Ophthalmol, 15 : 2835-45.

Sawa M. .2017 .Laser flare-cell photometer: principle and significance in clinical and basic ophthalmology. Jpn J Ophthalmol, 61(1) : 21-42.

Huang Q,Cheng GP,Chiu K,Wang GQ .2016 .Surface modification of intraocular lenses. Chin Med J (Engl), 129(2) : 173496-6999.

Luo C,Wang H,Chen X,Xu J,Yin H,Yao K. .2022 .Recent advances of intraocular lens materials and surface modification in cataract surgery. Front Bioeng Biotechnol, 10 : 913383.

Bayramlar H,Totan Y,Borazan M. .2004 .Heparin in the intraocular irrigating solution in pediatric cataract surgery. J Cataract Refract Surg, 07(10) : 2163-9.

Nema K,Hussain S K .2018 .Low molecular weight heparin in intraocular infusion in high risk group cataract surgeryminimizes inflammatory reaction and prevents posterior capsular opacification. J Med Sci Clin Res, 6(7) : 777-86.

Krall EM,Arlt EM,Jell G,Strohmaier C,Bachernegg A,Emesz M .2013 .Intraindividual aqueous flare comparison after implantation of hydrophobic intraocular lenses with or without a heparin-coated surface. J Cataract Refract Surg, 11(8) : 1363-70.

Krall EM,Arlt EM,Jell G,Strohmaier C,Moussa S,Dexl AK .2015 .Prospective randomized intraindividual comparison of posterior capsule opacification after implantation of an IOL with and without heparin surface modification. J Refract Surg, 31(7) : 20150623-72.

Safi AB,Rahimi I. .2019 .Heparin sodium uses in children's cataract surgery. Int J Res Biol Pharm, 5(9) : 1102-23.

Ozkurt YB,Taşkiran A,Erdogan N,Kandemir B,Doğan OK .2009 .Effect of heparin in the intraocular irrigating solution on postoperative inflammation in the pediatric cataract surgery. Clin Ophthalmol, 3 : 363-5.

Kumari D,Simakurthy S,Sharma N,Titiyal J,Kumar A,Chawla R .2024 .Comparison of clinical outcomes of implantation of foldable hydrophobic acrylic intraocular lens with and without heparin surface modification in Indian diabetic patients. Cureus, 16(3) : .

Maamri A,Zemova E,Moslemani K,Flockerzi F,Seitz B .2022 .Recurrent ligneous conjunctivitis after cataract surgery in a 67-year-old male patient: a case report. BMC Ophthalmol, 22(1) : 103.